The patient-reported disease burden in adults with atopic dermatitis: a cross-sectional study in Europe and Canada

M. de Bruin-Weller, A. Gadkari, S. Auziere, E. L. Simpson, L. Puig, S. Barbarot, G. Girolomoni, K. Papp, A. E. Pink, G. Saba, T. Werfel, L. Eckert

Research output: Contribution to journalArticle

Abstract

Background: Cross-sectional data on patient burden in adults with atopic dermatitis (AD) from real-world clinical practice are limited. Objective: This study compared patient-reported burden associated with adult AD across severity levels from clinical practices in Canada and Europe. Methods: This study included adults (18–65 years) diagnosed with AD by dermatologists, general practitioners or allergists. Participants categorized as mild (n = 547; 37.3%), moderate (n = 520; 35.4%) or severe (n = 400; 27.3%) based on Investigator's Global Assessment completed a questionnaire that included pruritus and pain numerical rating scales, Patient-Oriented-Scoring of Atopic Dermatitis (PO-SCORAD) itch and sleep visual analogue scales, Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). Participants were also stratified by inadequate efficacy/intolerance/contraindication to cyclosporine [Cyclo; n = 62 (4 mild, 18 moderate, 40 severe)] and any systemic immunomodulatory agent [IMM; n = 104 (13 mild, 31 moderate, 60 severe)] and compared with the severe group excluding participants identified as Cyclo/IMM. Results: Age was similar across severity groups; the proportion of women was higher in the mild group relative to severe (61.2% vs. 50.5%; P < 0.001). Compared with moderate and mild, participants with severe AD had more comorbidities, higher itch and pain severity, worse sleep and higher levels of anxiety and depression (all P < 0.001). Mean ± SD DLQI score among participants with severe AD (16.2 ± 6.9) showed a large effect on quality of life that was higher than those with moderate (10.2 ± 6.3) and mild (5.5 ± 4.9) (both P < 0.001). The burden among Cyclo and IMM subgroups was generally similar to that of participants with severe AD. Conclusions: Adults with AD reported a substantial burden across multiple domains that was significantly higher in those with severe disease. The burden among participants in the Cyclo/IMM subgroups was similar to those with severe AD.

Original languageEnglish (US)
JournalJournal of the European Academy of Dermatology and Venereology
DOIs
StateAccepted/In press - Jan 1 2019

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Atopic Dermatitis
Canada
Cross-Sectional Studies
Quality of Life
Dermatology
Sleep
Anxiety
Depression
Pain
Pruritus
Visual Analog Scale
General Practitioners
Cyclosporine
Comorbidity
Research Personnel

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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The patient-reported disease burden in adults with atopic dermatitis : a cross-sectional study in Europe and Canada. / de Bruin-Weller, M.; Gadkari, A.; Auziere, S.; Simpson, E. L.; Puig, L.; Barbarot, S.; Girolomoni, G.; Papp, K.; Pink, A. E.; Saba, G.; Werfel, T.; Eckert, L.

In: Journal of the European Academy of Dermatology and Venereology, 01.01.2019.

Research output: Contribution to journalArticle

de Bruin-Weller, M. ; Gadkari, A. ; Auziere, S. ; Simpson, E. L. ; Puig, L. ; Barbarot, S. ; Girolomoni, G. ; Papp, K. ; Pink, A. E. ; Saba, G. ; Werfel, T. ; Eckert, L. / The patient-reported disease burden in adults with atopic dermatitis : a cross-sectional study in Europe and Canada. In: Journal of the European Academy of Dermatology and Venereology. 2019.
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title = "The patient-reported disease burden in adults with atopic dermatitis: a cross-sectional study in Europe and Canada",
abstract = "Background: Cross-sectional data on patient burden in adults with atopic dermatitis (AD) from real-world clinical practice are limited. Objective: This study compared patient-reported burden associated with adult AD across severity levels from clinical practices in Canada and Europe. Methods: This study included adults (18–65 years) diagnosed with AD by dermatologists, general practitioners or allergists. Participants categorized as mild (n = 547; 37.3{\%}), moderate (n = 520; 35.4{\%}) or severe (n = 400; 27.3{\%}) based on Investigator's Global Assessment completed a questionnaire that included pruritus and pain numerical rating scales, Patient-Oriented-Scoring of Atopic Dermatitis (PO-SCORAD) itch and sleep visual analogue scales, Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). Participants were also stratified by inadequate efficacy/intolerance/contraindication to cyclosporine [Cyclo; n = 62 (4 mild, 18 moderate, 40 severe)] and any systemic immunomodulatory agent [IMM; n = 104 (13 mild, 31 moderate, 60 severe)] and compared with the severe group excluding participants identified as Cyclo/IMM. Results: Age was similar across severity groups; the proportion of women was higher in the mild group relative to severe (61.2{\%} vs. 50.5{\%}; P < 0.001). Compared with moderate and mild, participants with severe AD had more comorbidities, higher itch and pain severity, worse sleep and higher levels of anxiety and depression (all P < 0.001). Mean ± SD DLQI score among participants with severe AD (16.2 ± 6.9) showed a large effect on quality of life that was higher than those with moderate (10.2 ± 6.3) and mild (5.5 ± 4.9) (both P < 0.001). The burden among Cyclo and IMM subgroups was generally similar to that of participants with severe AD. Conclusions: Adults with AD reported a substantial burden across multiple domains that was significantly higher in those with severe disease. The burden among participants in the Cyclo/IMM subgroups was similar to those with severe AD.",
author = "{de Bruin-Weller}, M. and A. Gadkari and S. Auziere and Simpson, {E. L.} and L. Puig and S. Barbarot and G. Girolomoni and K. Papp and Pink, {A. E.} and G. Saba and T. Werfel and L. Eckert",
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T1 - The patient-reported disease burden in adults with atopic dermatitis

T2 - a cross-sectional study in Europe and Canada

AU - de Bruin-Weller, M.

AU - Gadkari, A.

AU - Auziere, S.

AU - Simpson, E. L.

AU - Puig, L.

AU - Barbarot, S.

AU - Girolomoni, G.

AU - Papp, K.

AU - Pink, A. E.

AU - Saba, G.

AU - Werfel, T.

AU - Eckert, L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Cross-sectional data on patient burden in adults with atopic dermatitis (AD) from real-world clinical practice are limited. Objective: This study compared patient-reported burden associated with adult AD across severity levels from clinical practices in Canada and Europe. Methods: This study included adults (18–65 years) diagnosed with AD by dermatologists, general practitioners or allergists. Participants categorized as mild (n = 547; 37.3%), moderate (n = 520; 35.4%) or severe (n = 400; 27.3%) based on Investigator's Global Assessment completed a questionnaire that included pruritus and pain numerical rating scales, Patient-Oriented-Scoring of Atopic Dermatitis (PO-SCORAD) itch and sleep visual analogue scales, Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). Participants were also stratified by inadequate efficacy/intolerance/contraindication to cyclosporine [Cyclo; n = 62 (4 mild, 18 moderate, 40 severe)] and any systemic immunomodulatory agent [IMM; n = 104 (13 mild, 31 moderate, 60 severe)] and compared with the severe group excluding participants identified as Cyclo/IMM. Results: Age was similar across severity groups; the proportion of women was higher in the mild group relative to severe (61.2% vs. 50.5%; P < 0.001). Compared with moderate and mild, participants with severe AD had more comorbidities, higher itch and pain severity, worse sleep and higher levels of anxiety and depression (all P < 0.001). Mean ± SD DLQI score among participants with severe AD (16.2 ± 6.9) showed a large effect on quality of life that was higher than those with moderate (10.2 ± 6.3) and mild (5.5 ± 4.9) (both P < 0.001). The burden among Cyclo and IMM subgroups was generally similar to that of participants with severe AD. Conclusions: Adults with AD reported a substantial burden across multiple domains that was significantly higher in those with severe disease. The burden among participants in the Cyclo/IMM subgroups was similar to those with severe AD.

AB - Background: Cross-sectional data on patient burden in adults with atopic dermatitis (AD) from real-world clinical practice are limited. Objective: This study compared patient-reported burden associated with adult AD across severity levels from clinical practices in Canada and Europe. Methods: This study included adults (18–65 years) diagnosed with AD by dermatologists, general practitioners or allergists. Participants categorized as mild (n = 547; 37.3%), moderate (n = 520; 35.4%) or severe (n = 400; 27.3%) based on Investigator's Global Assessment completed a questionnaire that included pruritus and pain numerical rating scales, Patient-Oriented-Scoring of Atopic Dermatitis (PO-SCORAD) itch and sleep visual analogue scales, Dermatology Life Quality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). Participants were also stratified by inadequate efficacy/intolerance/contraindication to cyclosporine [Cyclo; n = 62 (4 mild, 18 moderate, 40 severe)] and any systemic immunomodulatory agent [IMM; n = 104 (13 mild, 31 moderate, 60 severe)] and compared with the severe group excluding participants identified as Cyclo/IMM. Results: Age was similar across severity groups; the proportion of women was higher in the mild group relative to severe (61.2% vs. 50.5%; P < 0.001). Compared with moderate and mild, participants with severe AD had more comorbidities, higher itch and pain severity, worse sleep and higher levels of anxiety and depression (all P < 0.001). Mean ± SD DLQI score among participants with severe AD (16.2 ± 6.9) showed a large effect on quality of life that was higher than those with moderate (10.2 ± 6.3) and mild (5.5 ± 4.9) (both P < 0.001). The burden among Cyclo and IMM subgroups was generally similar to that of participants with severe AD. Conclusions: Adults with AD reported a substantial burden across multiple domains that was significantly higher in those with severe disease. The burden among participants in the Cyclo/IMM subgroups was similar to those with severe AD.

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